Definitions & Facts
Bone cancer develops when a cancerous or malignant tumor grows and destroys bone tissue. Not all bone tumors are malignant; some are benign. Benign tumor occur more commonly than malignant ones. Both may grow and compress bone tissue. Benign tumors never spread and rarely pose a threat while malignant tumors may be fatal if not treated early.
Cancers originating from the bone are called primary bone cancers as opposed to malignant tumors in the bone that have metastasized from other organs. Doctors name metastatic cancers according to the organ they originate from. Primary bone cancer is less common than metastatic cancers. There are three different categories of bone cancer:
- Osteosarcoma. It arises from the osteoid tissue. It frequently affects the upper arm and knee.
- Chondrosarcoma. It starts from cartilage which is the tissue that lines the joints and pads the ends of bones. Chondrosarcoma occurs in the shoulders, the pelvis region, and the upper leg area.
- Ewing Sarcoma Family of Tumors (EFTS) occurs in the bone but sometimes in the soft tissues: blood vessels, muscle, fat and fibrous connective tissue. These cancer types mostly affect the legs, arms, pelvis and spine
Symptoms & Complaints
Swelling is another common symptom. One may feel a lump or a swelling depending on the location of cancer. The swelling may not arise initially until a couple of weeks later. Joint stiffness and joint tenderness may limit the patient’s movement. Tumors of the neck or jaws may cause a lump to form and as it swells, may cause difficult swallowing and difficulty breathing.
Bone cancer also causes fractures which manifest as a crack in the bone rather than a complete limb breakage. It happens because the bones are weak from the pressure of malignant tumors. The patient may complain of sharp pains around the affected area that had been sore for a couple of months before.
Risk factors for bone cancer include certain genetic disorders that are known to cause bone disease. Children with the Rothmund-Thomson syndrome appear short and have thin bodies plus have rashes on their bodies. They are susceptible to osteosarcoma. Hereditary multiple exostoses causes several bumps on the bones. Sometimes they can be painful, cause deformities and even fracture the bones. This disorder makes someone at risk of developing bone cancer.
Having enchondromas may increase the risk of developing bone cancer. This is where a benign tumor grows on the bone cartilage. Paget disease causes abnormally dense, thick and brittle bones, and bone cancer develops in about 1% of individuals with the disorder.
In addition, exposure to large dosages of radiation increases the risk of contracting cancer of the bones. Bone marrow transplants also increase the likelihood of bone cancer, especially osteosarcoma.
Diagnosis & Tests
During diagnosis, a doctor needs to know about the patient’s personal and family’s medical history. He or she also performs a physical examination. Further tests may include:
- X-rays can show location, size and shape of a tumor. If the resulting test suggests cancer, the doctor would advise further imaging tests.
- Bone scans. The doctor injects a small amount of radioactive liquid into blood vessels, it then collects in the bone tissue. The doctor then examines the bone and finds the affected tissue.
- MRIs. A powerful electromagnet connected to a computer creates a detailed internal image of body organs.
- PET scan In this test, a radioactive glucose compound is injected into the blood. Computer imageries track usage of the glucose, and since cancer cells have an enormous appetite for glucose, their location will be found.
- CT scan. In this test, detailed images of the insides of a patient’s body are generated from every angle through a computer connected to an X-ray machine.
- Biopsy. The actual tissue affected is taken and tested. The doctor may perform an incision biopsy by cutting into the tumor, or a needle biopsy where he or she makes a small hole in the bone and takes a sample of the tissue.
Treatment & Therapy
A full range of treatments is available, but doctors must consider quite a number of factors to determine what treatment is suitable. The type, location, size, and stage play a role in determining treatment options. A person’s age and general health also play a huge part.
- Surgery is the most common treatment for bone cancer. Of late, improved surgical procedures do not require the whole limb removed.
- Another treatment option is chemotherapy where anticancer drugs kill the malignant cells. Currently, patients with chondrosarcoma cannot undergo this form of treatment.
- Radiotherapy involves the use of high-energy X-rays to kill cancerous cells. Doctors usually use it to treat chondrosarcoma and patients who do not want surgery.
- Cryosurgery is the use of nitrogen to freeze cancerous cell till they die.
Prevention & Prophylaxis